Abstract
Study design
Retrospective case-control study.
Objectives
To investigate signal changes on T1w/T2w signal intensity ratio maps within cervical cord in patients with degenerative cervical myelopathy (DCM).
Setting
Novosibirsk Neurosurgery Center, Russia.
Methods
A total of 261 patients with DCM and 42 age- and sex-matched healthy controls were evaluated using the T1w/T2w mapping method and spinal cord automatic morphometry. The T1w/T2w signal intensity ratio, which reflects white matter integrity, and the spinal cord cross-sectional area (CSA) were calculated and compared between the patients and the controls. In patients with DCM, the correlations between these parameters and neurological scores were also evaluated.
Results
The regional T1w/T2w ratio values from the cervical spinal cord at the level of maximal compression in patients with DCM were significantly lower than those in healthy controls (pā<ā0.001), as were the regional CSA values (pā<ā0.001). There was a positive correlation between the regional values of the T1w/T2w ratio and the values of the CSA at the level of maximal spinal cord compression.
Conclusions
T1w/T2w mapping revealed that spinal cord tissue damage exists at the level of maximal compression in patients with DCM in association with spinal cord atrophy according to automatic morphometry. These changes were correlated with each other.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
Data availability
Raw data were generated at Federal Neurosurgical Center Novosibirsk. Derived data supporting the findings of this study are available from the corresponding author on reasonable request.
References.
Yurac R, Matamala JM, Zamorano JJ, Harrop JS, Davies BM, Nouri A. et al. Degenerative cervical myelopathy. Rev Med Chil. 2022;150:339ā52.
Nouri A, Tessitore E, Molliqaj G, Meling T, Schaller K, Nakashima H, et al. Degenerative cervical myelopathy: development and natural history [AO Spine RECODE-DCM Research Priority Number 2]. Global Spine J. 2022;12:39S.
Badhiwala JH, Ahuja CS, Akbar MA, Witiw CD, Nassiri F, Furlan JC. et al. Degenerative cervical myelopathy - update and future directions. Nat Rev Neurol. 2020;16:108ā24.
Nouri A, Martin AR, Mikulis D, Fehlings MG Magnetic resonance imaging assessment of degenerative cervical myelopathy: a review of structural changes and measurement techniques. Neurosurg Focus. 2016 [cited 2022 Nov 29];40. Available from: https://pubmed.ncbi.nlm.nih.gov/27246488/.
Kim TH, Ha Y, Shin JJ, Cho YE, Lee JH, Cho WH Signal intensity ratio on magnetic resonance imaging as a prognostic factor in patients with cervical compressive myelopathy. Medicine (United States). 2016 [cited 2022 Dec 7];95. Available from: https://journals.lww.com/md-journal/Fulltext/2016/09270/Signal_intensity_ratio_on_magnetic_resonance.6.aspx.
Ponticorvo S, Manara R, Russillo MC, Erro R, Picillo M, Di Salle G, et al. Magnetic resonance T1w/T2w ratio and voxel-based morphometry in multiple system atrophy. Sci Rep. 2021 Dec 1 [cited 2022 Nov 29];11.
Sasiadek MJ, Szewczyk P, Bladowska J Application of diffusion tensor imaging (DTI) in pathological changes of the spinal cord. Med Sci Monit [Internet]. 2012 [cited 2022 Nov 29];18. Available from: https://pubmed.ncbi.nlm.nih.gov/22648262/.
Liu H, MacMillian EL, Jutzeler CR, Ljungberg E, MacKay AL, Kolind SH, et al. Assessing structure and function of myelin in cervical spondylotic myelopathy: evidence of demyelination. Neurology. 2017;89:602.
Martin AR, De Leener B, Cohen-Adad J, Cadotte DW, Kalsi-Ryan S, Lange SF. et al. A Novel MRI Biomarker of Spinal Cord White Matter Injury: T2*-weighted white matter to gray matter signal intensity ratio. AJNR Am J Neuroradiol. 2017;38:1266ā73.
He B, Sheldrick K, Das A, Diwan A. Clinical and research MRI techniques for assessing spinal cord integrity in degenerative cervical myelopathy: a scoping review. Biomedicines. 2022;10:2621.
Yang HE, Kim WT, Kim DH, Kim SW, Yoo WK, Yang HE. et al. Utility of diffusion and magnetization transfer MRI in cervical spondylotic myelopathy: a pilot study. Diagnostics. 2022;12:2090.
Glasser MF, van Essen DC. Mapping human cortical areas in vivo based on myelin content as revealed by T1- and T2-weighted MRI. J Neurosci. 2011;31:11597.
De Leener B, LĆ©vy S, Dupont SM, Fonov VS, Stikov N, Louis Collins D, et al. SCT: Spinal Cord Toolbox, an open-source software for processing spinal cord MRI data. Neuroimage. 2017;145:24ā43.
Ganzetti M, Wenderoth N, Mantini D. Whole brain myelin mapping using T1- and T2-weighted MR imaging data. Front Hum Neurosci. 2014;8:671.
Hannoun S, Kocevar G, Codjia P, Barile B, Cotton F, Durand-Dubief F. et al. T1/T2 ratio: a quantitative sensitive marker of brain tissue integrity in multiple sclerosis. J Neuroimag. 2022;32:328ā36.
Pareto D, Garcia-Vidal A, Alberich M, Auger C, Montalban X, TintorĆ© M. et al. Ratio of T1-weighted to T2-weighted signal intensity as a measure of tissue integrity: comparison with magnetization transfer ratio in patients with multiple sclerosis. Am J Neuroradiol. 2020;41:461ā3.
Fischl B. FreeSurfer. Neuroimage. 2012;62:774.
Martin AR, de Leener B, Cohen-Adad J, Cadotte DW, Kalsi-Ryan S, Lange SF, et al. Clinically feasible microstructural MRI to quantify cervical spinal cord tissue injury using DTI, MT, and T2*-weighted imaging: assessment of normative data and reliability. AJNR Am J Neuroradiol. 2017;38:1257ā65.
Cohen-Adad J, Alonso-Ortiz E, Abramovic M, Arneitz C, Atcheson N, Barlow L, et al. Open-access quantitative MRI data of the spinal cord and reproducibility across participants, sites and manufacturers. Scientific Data 2021 8:1 [Internet]. 2021 Aug 16 [cited 2022 Dec 1];8:1ā17. Available from: https://www.nature.com/articles/s41597-021-00941-8.
Teraguchi M, Yamada H, Yoshida M, Nakayama Y, Kondo T, Ito H. et al. Contrast enrichment of spinal cord MR imaging using a ratio of T1-weighted and T2-weighted signals. J Magn Reson Imaging. 2014;40:1199ā207.
Bansal R, Hao X, Liu F, Xu D, Liu J, Peterson BS. The effects of changing water content, relaxation times, and tissue contrast on tissue segmentation and measures of cortical anatomy in MR images. Magn Reson Imaging [Internet]. 2013;31:1709.
Boaventura M, Sastre-Garriga J, Garcia-Vidal A, Vidal-Jordana A, Quartana D, Carvajal R, et al. T1/T2-weighted ratio in multiple sclerosis: a longitudinal study with clinical associations. 2022.
Author information
Authors and Affiliations
Contributions
Conceptualization, EF, VL, and JR; methodology, EF, VL, and BZ; formal analysis, EF and VL; data curation, YK and JR; investigation, EF, BZ, and VL; resources, JR; writingāoriginal draft preparation, EF and BZ; writingāreview and editing, JR and YK; visualizationāEF; supervision, YK and JR; project administration, JR. All authors have read and agreed to the published version of the manuscript.
Corresponding author
Ethics declarations
Competing interests
The authors declare no competing interests.
Ethical approval
Data acquisition and publication were in accordance with the principles outlined in the Declaration of Helsinki. The study was approved by the local Ethics Committee of the Federal Center for Neurosurgery, Novosibirsk, Russia (protocol No. 6 dated 02-08-2022).
Additional information
Publisherās note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary information
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Filimonova, E., Letyagin, V., Zaitsev, B. et al. Application of the T1w/T2w mapping technique for spinal cord assessment in patients with degenerative cervical myelopathy. Spinal Cord 62, 6ā11 (2024). https://doi.org/10.1038/s41393-023-00941-y
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/s41393-023-00941-y